Navigating CMS Changes and Clinical Documentation in Rural Orthopedics with Dr. Sylvester Youlo
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What is the main topic discussed in this episode?
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What insights does Dr. Sylvester Yulo share about his background and Phelps Health?
Hello and welcome to the Becker's Healthcare Podcast. My name is Chanel Bunger and today is a pleasure of speaking with Dr. Sylvester Yulo, an orthopedic surgeon at Phelps Health, who joins the podcast today to share insights into his background, healthcare trends he's keeping an eye on, and a bit more. Dr. Yulo, thank you so much for joining me today.
Thank you for having me, Chanel.
Perfect. Well, to get us started out, could you please introduce yourself, tell us a bit about your background and Phelps Health?
Okay. Well, my name is Dr. Sylvester Yulo. I'm an orthopedic surgeon. I'm employed by Self Health, a rural hospital in Missouri. We actually are located about 90 miles from St. Louis and 90 miles from Springfield.
What healthcare trends is Dr. Yulo currently monitoring in orthopedics?
So we are kind of in the middle. We service about 250,000 people. And our hospital mostly service a U.S. military installation around here called Fort Leonard Wood. So we take care of the families there and the service members. My practice is general orthopedics. I cover joint replacement trauma, and I have a special niche in sports surgery. I also have two master degrees, an MBA and a master in health administration, because I strongly believe that physicians must understand how healthcare works financially to be able to serve patients long-term.
Got it, got it. Thank you so much for that introduction. And now moving forward, what health care trends are you currently watching in your role today, either in orthopedics or just health care overall?
Well, really, the biggest thing really I'm watching out for is how things are changing with TMS. Almost every few months recently, there have been changes to everything going We're just going to outpatient only, at least leaving the inpatient only list to the outpatient list.
How is the shift to outpatient care affecting surgical practices?
And also there are multiple regulations that have been coming out and changing physician reimbursement, hospital reimbursement. Those are actually the biggest trends we're watching out for right now.
Absolutely. And so kind of looking forward into the rest of the year, what are you most focused on and excited about? And then kind of looking back at last year, can you talk about an initiative or a project that you're most proud of?
Yes. So here, so one thing started changing, especially with the inpatient unit list being changed, we decided our organization to focus on a lot of different, differently than most people are doing, on clinical documentation. So, you know, when we went to medical school, documenting was about, you know, if you didn't write it down, you didn't perform it. It was about, you know, documenting so patients would know what happened. for medical legal purposes. But what really is happening now is that documenting the care that's performed is very important. So about a year ago, almost two years ago, we decided to start a CDI initiative at our institution. And what we decided to do was have buy-in from physician and everybody else, to understand the nuance here about documenting the care that we provide, so that once TMS got to know what we did, all insurance companies figured out what we did, getting reimbursed was a little easier.
The initial purpose of that initiative really wasn't about reimbursement, really. It was about increasing our TMI. TMI is really case match index. That number is very important. in documenting how sick the patient we treat are. And that's what we're trying to go after. But once we did that, what we did realize was, overall, it benefited patients, it benefited the system, it decreased, you know, how much bills were in our, it decreased our denials, increased our reimbursement rate, and those things changed.
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Chapters
5 chapters
1
What is the main topic discussed in this episode?
0:01–0:38
2
What insights does Dr. Sylvester Yulo share about his background and Phelps Health?
0:38–1:17
3
What healthcare trends is Dr. Yulo currently monitoring in orthopedics?
1:17–2:25
4
How is the shift to outpatient care affecting surgical practices?
2:25–5:28
5
What is the importance of clinical documentation in healthcare?
5:28–8:16
Speakers
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